Welcome to our comprehensive guide on meniscal tears, a common yet often misunderstood knee injury. Whether you’re an athlete, fitness enthusiast, or simply seeking to safeguard your knee health, understanding meniscal tears is crucial. Join us as we unravel the causes, symptoms, diagnosis, treatment options, and essential tips for a speedy recovery.

Let’s begin with the anatomy of the knee

The knee is one of the largest joints in the human body and is a hinge-type synovial joint that primarily allows for flexion (bending) and extension (straightening). The primary articulations of the knee are tibio-femoral (where the shin bone meets the thigh bone) and patellofemoral (where the kneecap sits in a groove on the femur). An extensive network of ligaments, cartilage and muscles provide support, stability and allow for fluid movement of the knee. 

The “meniscus” is the term used to describe the fibrous cartilage that sits in the space between the femur (thigh bone) and the tibia (shin bone). The role of the meniscus is to increase stability, absorb shock and provide congruency to the knee joint. There are two menisci in the knee, one on the inside and one on the outside.

What is a meniscus tear?

A meniscus tear refers to a tear in the fibrous cartilage in the knee joint. It can occur either by trauma, such as forceful twisting with a planted foot (very common in sport), or due to natural wear and tear processes as part of every day living. Medial meniscus tears on the inside of the knee are more commonly reported than lateral and meniscus tears make up 15% of all sporting injuries, therefore its something we see a lot in clinic.

What can be done about a meniscus tear?

Recent research has been looking into the best ways to treat meniscus tears. One study, conducted between 2014 and 2018, found that for younger patients (average 35 years old) with isolated meniscus tears caused by injury, early arthroscopic surgery was no better than physiotherapy treatment.

In another study, they wanted to determine whether exercise-based physiotherapy was as good as arthroscopic surgery for patients aged 45 to 70 with meniscus tears caused by degeneration. The results showed that physiotherapy was just as effective as the surgery during a 5-year follow-up period.

Physiotherapy can help to relieve pain and build strength and support around the knee, as well as mobilise the joint after a meniscus tear, helping with return to functional activities. Exercise therapy, soft tissue techniques and manual therapy may comprise part of a physiotherapy programme for meniscus tears. 

Injection therapy may also be considered as an effective treatment. Injections are injected into the knee joint to alleviate pain, reduce inflammation and promote healing. Different types of injections may be used including corticosteroids or hyaluronic acid injections. Corticosteroids are potent anti-inflammatory medications that can quickly reduce pain and swelling in the joint, while hyaluronic acid can enhance the joint’s lubricating properties to help reduce impact and ease pain.

What if the tear is really big?

In the case of a large tear, often referred to as a ‘bucket-handle’ meniscus tear, surgical intervention is likely to be necessary. This refers to a type of tear where a large portion of the meniscus is displaced into the joint. It is called ‘bucket-handle’ because of the appearance of a bucket handle flipping. These types of tears are more severe and more likely to cause complications if left untreated. 

Remember as always early detection and management are key to a successful outcome, our team are all trained in detecting this common knee injury and with a good screening assessment, accurate diagnosis and timely management we can often get you back to doing what you love. If you have any queries don’t hesitate to contact a member of the team.